Catastrophic Out-Of-Pocket Health Expenditures In Ghana: Incidence, Intensity And Determinants.

Abstract

This study investigates the prevalence, intensity, and determinants of catastrophic health expenditures (CHE) among Ghanaian households using data from the 2016/2017 Ghana Living Standards Survey Round 7 (GLSS 7), which covered approximately 14,009 households. Using a combination of indices, concentration measures, and logistic regression models, the study examines how healthcare costs disproportionately affect different socio-economic groups, particularly low-income and rural households. Results show that at the 10% threshold, 4.65% of households experience CHE, with the poorest quintile bearing the highest burden at 9.05%. Although the incidence decreases at higher thresholds, such as 40%, the financial intensity among affected households increases sharply, reaching 58.69%. Key factors associated with CHE include higher household expenditure, older age, hospitalisation, and rural residence. While education and health insurance offer some protection, their effectiveness is limited, and users of the National Health Insurance Scheme (NHIS) still face significant financial strain. The study concludes that despite the presence of NHIS, gaps in healthcare financing persist, leaving vulnerable populations at risk. To address these challenges, it recommends expanding NHIS coverage, improving healthcare access in rural areas, introducing targeted financial support for low-income households, and enhancing public awareness of health financing options. Strengthening data-driven policymaking and integrating healthcare financing into broader social protection systems are also essential. The findings highlight the urgent need for comprehensive reforms to ensure equitable healthcare access and protect households from the economic burden of medical expenses in Ghana.